Money, sex & power pose challenge to treatment

How patients relate to money, sex and power can hinder the treatment process for mental illness or help reveal important insights, says Michael Groat, PhD, director of the Professionals in Crisis treatment program at The Menninger Clinic. The three age-old influences are the subject of the Institute for Spirituality and Health's 20th Annual Psychotherapy & Faith Conference, "Money, Sex and Power: The Danger for Psychotherapists and Clergy Alike," November 11 at St. Paul's United Methodist Church in Houston.

According to Dr. Groat, the roles of money, sex and power are frequently examined during mental health treatment:

Money—We often tie our self-worth to the amount of money we have. "For patients, money can be closely connected to their sense of status and identity," Dr. Groat says. That identity can stymie treatment when patients feel entitled to operate outside the boundaries necessary for good treatment (such as expecting unlimited availability from mental health professionals). On the other end of the spectrum, some patients have difficulty reaching out for help or finishing treatment because they believe they aren"t worth the expense.

Sex—Cultural taboos and prohibitions discourage many patients from talking about sex in therapy, Dr. Groat says. Some professionals he treats struggle with declining sexual attractiveness, impotence, lack of sexual intimacy in relationships, sexual addiction or addiction to pornography. Other patients may hope to find sexual gratification during treatment—often attempting to use sex as a way to manage difficult feelings.

Power—"People often feel conflicted about their own power," Dr. Groat says, adding that patients frequently fall into two camps—either they feel powerless about taking charge of their own lives, or abuse their power and bully others. Patients who feel powerless have difficulty taking personal responsibility and action toward their own treatment. Power abusers and bullies may be reluctant to accept direction and help from mental health professionals.